A water-skier was sent by medical flight to the hospital after collision with a boat following a…

A water-skier was sent by medical flight to the hospital
after collision with a boat following a 30-feet acrobatic jump. The unknown
young man was intubated with a 7.0-mm ETT at the scene for hypoxemia and GCS 6
with no lower limb movements. Vital signs at admission in the ED were heart
rate 40 beats/min, blood pressure 80/40 mm Hg, O2 saturation 99%, and body
temperature 35°C. He weighs 160 lb and is 6 ft tall. The ventilator settings
are as follows: volume-controlled ventilation mode, tidal volume (VT)
500 ml, respiratory rate 14 breaths/min, and positive end expiratory pressure
(PEEP) 5 cm H2O. During central line placement, the RT notices that
the peak airway pressure increased from 18 cm H2O to 35 cm H2O,
activating the high pressure alarm, and SaO2 declined rapidly from
99% to 90%. What are the next steps the RT should take?

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